Findings from histologic examination showed a dense lymphocytic infiltrate demonstrating extensive epidermotropism with focal Pautrier-like microabscesses. High-power microscopic examination revealed atypical lymphocytes with enlarged, pleomorphic, hyperchromatic nuclei with occasional cerebriform nuclear contours. Lymphocytes were CD3 positive. Additional immunostains revealed an unusual pattern, with the atypical lymphocytes showing weak CD4 staining results and negative CD8 staining results. There was mild loss of expression of CD7. There were few CD20+ and CD30+ lymphocytes. T-cell receptor analysis by polymerase chain reaction detected a clonal population within the biopsy specimen. Overall, the findings were consistent with a diagnosis of cutaneous T-cell lymphoma (CTCL).